Etiological analysis of bile of bile duct stone patients with infections

OBJECTIVE To investigate the distribution of pathogens in the bile of the bile duct stone patients complicated with biliary tract infections so as to guide the reasonable clinical use of antibiotics.METHODS A total of 185 cases of bile duct stones patients complicated with biliary tract infections,who were treated in the hospital from Mar 2011to Mar 2013,were enrolled in the study,then the bacterial culture of the bile and the drug susceptibility testing were performed,the distribution of pathogens in the bile and the drug resistance were analyzed.RESULTS Totally 124strains of pathogens were isolated from 185 bile specimens with the detection rate of 67.03%,including 91(73.39%)strains of gram-negative bacilli and 33(26.61%)strains of gram-positive cocci;the Escherichia coli,Klebsiella pneumoniae,and Pseudomonas aeruginosa were the predominant species of gramnegative bacilli,accounting for 35.48%,11.29%,and 8.87%,respectively;the Enterococcus faecalis and Enterococcus feces were dominant among the gram-positive cocci,accounting for 15.32% and 8.87%,respectively.The drug resistance rates of the E.coli to ampicillin and cotrimoxazole were 62.18% and 92.86%,respectively;the drug resistance rates of the K.pneumoniae were 52.27% and 21.43%,respectively;the drug resistance rate of the E.coli was significantly higher than that of the K.pneumoniae to ciprofloxacin or levofloxacin(P0.05);the P.aeruginosa was sensitive to ciprofloxacin and levofloxacin,with the drug resistance rate less than 10.0%;the drug resistance rate of the E.feces was significantly higher than that of the E.faecalis to ampicillin,penicillin,levofloxacin,or azithromycin,the difference was significant(P0.05),there were no strains of E.faecalis or E.feces detected resistant to vancomycin,teicoplanin,or nitrofurantoin.CONCLUSION The new change of pathogenic spectrum has emerged in the bile of the bile duct stone patients complicated with biliary infections;it is necessary to choose effective antibiotics based on the result of drug susceptibility testing.